The Art of Medicineover 2,000 years of images and imagination

Julieanderson | EmmBarnes | Emmashackleton

ForEword by antony gormley

The Art of Medicine

Astrology played a key role in medicine throughout many societies from ancient history, until modern scientific methods became predominant. It related to the belief that the movements of the stars influenced conditions on Earth, from the weather to the workings of the human body. The reliance on astrology was so great that in the 16th century physicians in Europe were required to calculate the position of the moon before carrying out procedures such as bleeding or surgery.

ContentsContents

8 Foreword by Antony Gormley

10 IntroductionMedicine is a practice that touches each of us in our lives, and it can have a powerful impact on our bodies, minds, and emotions. It is an area that is rich, too, in imagery and objects that served many roles within research, instruction, and information-giving through to high and popular art and religious faith. We set out the themes that will be explored, explain why we are drawing on the visual material of the Wellcome Collection, and highlight how Sir Henry Wellcome built the remarkable holding.

16 Mapping the Body Here we focus on the discoveries and thoughts about how the human body is structured and how it works. We take the reader on a visual journey, throughout history and across cultures, from our bodies as a whole to the genetic research currently underway.

80 Medicine in Our LivesWhat role has medicine played in our lives throughout history, and how has its practice been depicted, from scenes of caring physicians tending to patients to caricatures of quack doctors plying their trade?

120 Understanding Illness and Developing CuresHow have cultures understood illness, what kinds of cures have they developed, and how has medical practice been depicted? For example, in China doctors developed a treatment system based around acupuncture for many illnesses, while in Western Europe for centuries medical practitioners carried out treatments that were derived from the philosophies of the Greek scholars Hippocrates and Galen.

172 Treating with Surgery and Healing WoundsSurgery can range from minor to major operations, and until the introduction of pain relief and discoveries of how to maintain cleanliness, it was often a traumatic and dangerous intervention. Here, through the imagery, we explore surgical treatment across time and cultures.

206 Understanding Mental Health and Treating IllnessHow have cultures understood mental health and illness, and how have they sought to cure and care for those diagnosed with a disorder? Through the imagery in the Collection we gain an insight into perceptions of patients by others, practitioners carrying out their roles, and individuals’ own experiences.

224 Staying Well We often think of medicine as a resource for when we are poorly, yet it has always played a role in enabling us to maintain our wellbeing, whether historically through ceremonies to ward off evil spirits or through periodic visits to physicians for blood letting to maintain the balance of our blood and health.

248 Bibliography and Further Resources254 Index256 Acknowledgments

Left Astrological man, PersiaAbout 19th centuryWatercolor illustration taken from the Persian manuscript of the Zakhira-i Khvarazm Shahi of al-Jurjani and Tashrih-i Mansuri of Mansur.

Above Astrological man, EuropeLate 14th centuryA folding almanac, featuring a calendar, information, and medical summaries. The image of the man shows the astrological signs that rule the body parts, and was published in the Medical Practitioner’s Handbook of 1463.

Far left A facsimile of an original painting of an Aztec Astrological ManAbout 1830By Edward King Kingsborough and published in Antiquities of Mexico, 1831.

Interior of a Surgeryfollower of David Tenier the younger (1610–1690)after the 1670soil on canvas57 x 81 cm

David Tenier was renowned for his paintings of everyday life, which are technically skilled and rich with detail. This work was made after his own painting of the same subject (now in the Chrysler Museum, Norfolk, USA). At one level the painting appears to depict a straightforward scene of a surgeon at work with his

The Art of Medicine

assistants. However, Tenier also communicates with viewers on another level, by including unexpected figurative elements such as the monkey—a traditional Western symbol of lust—depicted here eating an apple and shackled with a ball and chain.

Treating with Surgery and Healing Wounds The Operating Theatre

Before the late nineteenth century, operations were performed in a variety of places, from the barber-surgeon’s shop to the patient’s home. This began to change in the 1880s, when well-equipped and well-maintained operating theatres were designed and built in hospitals. In these new purpose-built facilities, instruments and surfaces could be sterilised and adequate lighting could be provided for, a vast improvement on the primitive conditions often found in back-street shops or in patient’s homes. These new operating theatres were often high up in the ceilings of the building to take advantage of available light, for example, the operating theatre in the Royal Orthopaedic Hospital in Birmingham was originally located in the conservatory of the converted estate. New technology available in hospitals during the nineteenth century allowed practitioners to perform more complicated procedures. Wilhelm Röntgen’s discovery of x-rays in 1895 allowed surgeons to see into the body without the aid of a scalpel for

The Operating Theatre

the first time in history. The first electrocardiograph devised by Willem Einthoven enabled medics to monitor activity of the heart and diagnose cardiac disorders. These innovations, along with the use of anaesthetic and antisepsis, meant that surgery was more successful, and consequently, more commonly undertaken, than ever before. It was during this time that the traditionally conservative attitude to surgical intervention swung to the opposite extreme, and some surgeons were accused of being cavalier with their knives. Between the 1920s and the 1950s some practitioners advocated the removal of yards of gut as a cure for constipation, or performed unnecessary hysterectomies and tonsillectomies. Despite these controversies of practice, discoveries to aid diagnosis and define the course of surgical treatment continued to be made throughout the twentieth century. In the 1950s, the ultrasound allowed doctors to view the foetus in development and prepare for possible complications during

A “Theatre” of Medicine and SurgeryJohann Heinrich Rambergcirca1800watercolour 29.5 x 43.2 cm

Here, the Hanoverian artist Johann Heinrich Ramberg has created a nightmarish scene of surgery in a grand setting. Despite the splendour of the architecture, the medical practice appears in total disarray. To the left and right of the entrance, amputations are taking place on the surgical tables amid the commotion of various figures, including possible patients, medical operators and representatives of religious orders.

childbirth. Later twentieth century developments included CAT (computerised tomograph) PET (positron-emission tomographic scanning) and MRI (magnetic resonance imaging) scans which provided medical practitioners with an unprecedented view of the internal functions, and crucially—malfunctions—of the body. In addition to these diagnostic technologies, surgical technique also progressed during the twentieth century. Keyhole surgery for gall bladders, cartilage removal and investigative procedures has reduced the impact of intervention on the patient and often reduces the time spent in hospital recovering from the procedure. Nowadays, most operating theatres in the developed world house impressively advanced technology where highly skilled staff carry out complicated procedures, survival rates are high and distress to patients is kept to a minimum.

The Art of Medicine

Above “Tabloid” First-Aid for All Emergenciesartist unknownearly 1900sphotomechanical print[size?]

Left: “The Finest Tonic, Fer Bravais”“We don’t mind if it wets us through...”artist unknowntrade card late 1890s8 x 12 cm

Below LeftFer Bravais Contre L’anémieAdolphe-Léon Willetteartist unknowncirca 1890/96colour lithograph56 x 39.3 cm

Sir Henry Wellcome and Silas Burroughs were consummate marketeers, and this advertise-ment for a “Tabloid” First-Aid is a good example of their approach. They would often supply specially made medicine chests—featur-ing their own medicines and preparations—to figures in the public eye, including royalty, notable explorers and famous adventurers. In response, the

company would often receive enthusiastic endorsements from the recipients, which were to prove highly effective for advertising, enabling Wellcome and Burroughs to associate the company with adventure and heroism. In this example, the “Tabloid” first aid kit evokes Robert Falcon Scott and Ernest Shackleton’s journeys to Antarctica, Louis Blériot’s

Many commercial tonics in the late nineteenth and early twentieth centuries claimed wide-ranging health benefits, and Fer Bravais was no exception. The tonic was publicised as a cure for various ailments and for “being effective in restoring the vitality of the blood“. In the two advertisements shown here, the manufacturer portrays sentimental scenes of vulnerable children or, in the French poster, exhausted workers to create a resonance with the potential buyer.

flight across the English Channel in 1909, expeditions to the world’s highest mountains and Henry Stanley’s explorations in Africa.

Staying Well Fortification

Early medicinal preparations have often been associated with ‘snake oil merchants’, those selling tonics that supposedly cure all ills. By the late nineteenth and early twentieth century, commercial preparations became available to treat a whole range of conditions, from anaemia to consumption. As popular knowledge increased around the subject of vitamins and minerals during the first half of the twentieth century, a greater number of medical products were manufactured and marketed to satisfy a growing demand for treatments to preserve the health of a paying public. Fer Bravais was one such product. It was manufactured in France to control anaemia, but it was marketed and sold in countries as distant as Australia. Endorsements printed in newspapers from respected medical publications such as The Lancet, coupled with its promise not to cause consti-pation or blacken teeth, meant that Fer Bravais enjoyed huge success as a commercial product. Another popular fortifying preparation in the nineteenth century was cod liver oil, used to address the widespread incidence of rickets in poorer children from industrialised countries. Although its first documented use was in 1789, it wasn’t until the late nineteenth century that the use of cod liver oil became widespread. Many unwilling children choked down a daily dose of the preparation, originally manufactured by fermenting cod livers in seawater for up to a year. Unpleasant as it may have been, the supplement (along with ensuring that children were exposed to a healthy amount of sunlight) has gone a long way to eradicating rickets in many parts of the world.

Kalzana. Banishes Weakness and Disturbances of the Systemartist unknownabout 1930colour Lithograph58.4 x 46 cm

The young woman in this advertisement is a picture of vitality, making for an appealing endorsement of Kalzana, a calcium preparation popular in the 1920s and 1930s. When setting out its medicinal properties, the manufacturer J.A. Wulfing described the product as “calcium in chemical combination with sodium”, and promoted its benefits for pregnancy, menstrual problems, nervous complaints, eczema and good teeth, as well as a defence against malaria, chilblains and tuberculosis.

Fortification

12 x 12 · 256 pages

350 color plates, 50 halftones

ISBN-13: 978-0-226-74936-5

Publication date: September 2011

Cloth: $50.00

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The Art of MEdICINEOvEr 2,000 YEarS OF IMagES aNd IMagINaTION

JULIE aNdErSON | EMM BarNES | EMMa ShaCkLETON

WITh a FOrEWOrd BY aNTONY gOrMLEY

Since ancient times people have depended on medical practitioners to enhance life, to treat illness and injuries, and to help reduce pain and suffering. The scientifically based discipline that we know to-day stands beside diverse traditions, belief systems, and bodies of medical knowledge that have evolved in fascinating ways across cultures and continents. Throughout this history, successive genera-tions have created artistic representations of these varied aspects of medicine, illustrating instruction manuals, documenting treat-ments, and creating works of art that enable individuals to express their feelings and ideas about medicine, health, and illness. From ancient wall paintings and tomb carvings to sculpture, installations, and digitally created artworks, the results are extraordinary and pay tribute to how medicine has affected our lives and the lives of our ancestors.

Drawing on the remarkable holdings of the Wellcome Collec-tion in London, The Art of Medicine offers a unique gallery of rarely

seen paintings, artifacts, drawings, prints, and extracts from manu-scripts and manuals to provide a fascinating visual insight into our knowledge of the human body and mind, and how both have been treated with medicine. Julie Anderson, Emm Barnes, and Emma Shackleton take readers on a fascinating visual journey through the history of medical practice, exploring contemporary biomedical images, popular art, and caricature alongside venerable Chinese scrolls, prehistoric Mesoamerican drawings, paintings of the Euro-pean Renaissance, medieval Persian manuscripts, and more. The result is a rare and remarkable visual account of what it was and is to be human in sickness and health.

Julie Anderson and Emm Barnes are science outreach officers with Royal Holloway, University of London. Emma Shackleton is an edi-tor and writer specializing in the visual arts who has worked with the National Gallery and the National Portrait Gallery in London.